UCSF and Kaiser Permanente Northern California are teaming up to create the Northern California Regional Coordinating Stroke Center (NorCal-CSC) as one of the 25 sites in consideration for the Stroke Trials Network. NorCal-CSC combines the brain trust of stroke researchers at UCSF and Kaiser and leverages the infrastructure for multicenter research at these institutions that is already in existence. UCSF has been a leader in stroke research for over 2 decades; the creation of NorCal-CSC allows our combined efforts to crystalize into an efficient center that has expertise in Phase 1 and 2 trials and broad access to patient populations for large phase 3 trials as well. Kaiser Permanente Northern California covers over 3 million lives as registered patients, and coupled with a high-quality comprehensive electronic medical record, our ability to recruit patients for phase 3 trials of prevention and recovery is likely unparalleled. NorCal-CSC has many leaders in academic stroke research including Dr. S. Claiborne Johnston, Dr. Donald Easton and Dr. Wade Smith (PI) who will solicit fresh, meaningful clinical trial ideas from the broad range of stroke researchers at UCSF and Kaiser and present these to the STN as a whole for consideration. These leaders have led major, multi-center clinical trials and have extensive experience with the NIH funded NETT. This involvement with the NETT provides excellent experience to maintain a similar U-10 supported infrastructure for stroke research. NorCal-CSC will combine UC Medical Center (UCMC), San Francisco General Hospital (SFGH), UC-Fresno, and 2 Kaiser hospitals - all of which have primary stroke center status. Additionally, 3 of these hospitals have endovascular capability and all have capacity for advanced neuroimaging. Northern California is racially diverse with Asian (10-33%) and Hispanic patients (9-50%) representing significant populations across our sites; this racial diversity allows NorCal-CSC to study stroke prevention, treatment and recovery in these diverse populations. NorCal-CSC will also provide an accredited 2-year vascular neurology fellowship that includes advanced training in clinical trial design, trial implementation and center administration so as to prepare these individuals as leaders of stroke research in the future.